Opioid Abuse: Department of Veterans Affairs Culpability?

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While many families will be celebrating Easter today, I am quite sure that their thoughts will turn to a family member or friend who were among the 52,000 that died of a drug overdose last year.

By comparison, there were only 33,000 traffic fatalities over the same period.  These statistics suggest that substance abuse plays a far greater threat to our society than careless driving.

In an excellent 5-part series by FOX News entitled “Drugged, Inside the Opioid Crisis,” the network explores the devastating impact of opioid abuse in towns across the United States.

In fact, the FOX network claims that 4 out of 5 overdose fatalities can be traced to the initial use of prescription drugs for pain medication.   It is clear that prescription painkillers have caused many innocent victims to become dependent on more lethal drugs like heroin.

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As Stand for The Troops (“SFTT”) has been reporting for several years, Veterans suffering from PTSD have been regularly over-served with a concoction of drugs – primarily opioids – to allow them to cope with pain and other issues.

If there was any doubt about the culpability of the Department of Veterans Affairs (“the VA”) in addicting our Veterans to painkillers rather than treat them, I suggest that you watch the video below:

With 20-20 hindsight most everyone can be on the “right side of history,”  but our Veterans, the VA and Congressional oversight committees have known that opioids was not the proper way to treat Veterans suffering from PTSD and TBI.

Dr. David Cifu:  A State of Denial at the VA

Unfortunately, VA protocols to treat PTSD as articulated by Dr. David Cifu, the senior TBI specialist in the Department of Veterans Affairs’ Veterans Health Administration, have resulted in few lasting benefits for Veterans with PTSD.  Paraphrasing Dr. David Cifu,  “the worse thing you can do for someone with PTSD is not to press them back into action as quickly as possible.  At the VA, we prescribe drugs for those in pain or suffering trauma.”

Indeed, there is no compelling evidence that the VA has improved the lives of Veterans suffering from PTSD or TBI.  

The VA continues to push its stale and failed agenda that states that the only two effective treatment therapies offered by the VA are:

– Cognitive Behavioral Therapy and,

– Prolonged Exposure Therapy.

To see how badly the VA has failed our Veterans, one only needs to listen to a detailed explanation by Maj. Ben Richards citing his experience with the VA and a summary of failed patient outcomes at the VA. Watch the first two minutes to see Maj. Richards refute all VA claims that they are dealing with the problem effectively.

Conversation with a Veteran Drug Abuse Specialist

Several years ago, I had the opportunity to visit a Community Center in northern New York that was working with high-risk Veterans suffering from PTSD and TBI.  During this visit, I encountered a Drug Abuse Specialist, who had been rescued from addiction through the Veteran Court System.

What he told me shocked me.

– Well over 90% of Veterans returning from Iraq and Afghanistan suffer from substance abuse issues;

– Veterans are well aware that opioids don’t work and have major side-effects (i.e. suicidal thoughts) when combined with other prescription drugs provided by the VA;

– Rather than flush prescription drugs down the toilet, the drug of choice, OxyContin, was pulverized into powder and sold on the black market to civilian drug users;

– A leading supplier of OxyContin to the VA had its sales of the drug fall by more than 60% when Congress forced them to repackage the pills in a gel composite so it couldn’t be sold as a powder on the black market;

– This same pharmaceutical company petitioned Congress to reinstate OxyContin in pill form citing that “it is more effective than gel;”

– VA prescribed drugs don’t provide Veterans with a meaningful road to full recovery.

Sadly, I don’t believe the situation has changed significantly in recent years.

Opioid Abuse in the United States

The magnitude of the addiction problem in the United States can’t be underestimated.  Consider these staggering statistics from the American Society for Addiction Medicine (ASAM):

– Drug overdose is the leading cause of accidental death in the US, with 52,404 lethal drug overdoses in 2015. Opioid addiction is driving this epidemic, with 20,101 overdose deaths related to prescription pain relievers, and 12,990 overdose deaths related to heroin in 2015.

–  The overdose death rate in 2008 was nearly four times the 1999 rate; sales of prescription pain relievers in 2010 were four times those in 1999; and the substance use disorder treatment admission rate in 2009 was six times the 1999 rate.

– In 2012, 259 million prescriptions were written for opioids, which is more than enough to give every American adult their own bottle of pills.

– Four in five new heroin users started out misusing prescription painkillers.

– 94% of respondents in a 2014 survey of people in treatment for opioid addiction said they chose to use heroin because prescription opioids were “far more expensive and harder to obtain.

Opioids for Veterans: Deja Vu All Over Again

It’s often said that the definition of insanity is doing the same thing over and over again and expecting a different outcome.  As previous articles from SFTT have argued, the VA is in a rut and will continue to pursue well-meaning but demonstrably ineffective procedures to help Veterans with PTSD.  Most tragic.

While one would think that there is compelling evidence for the VA to follow in a different tack, I read a few days ago that OxyContin is again being tested to treat PTSD and substance abuse.

How much longer to our Veterans need to suffer from the VA bureaucracy and autocratic controls that remains largely unresponsive to their very real needs?   Based on the evidence, it seems that the VA management philosophy of benign neglect will continue to persist.  How sad!

Easter Advice from Veteran Wives Who Care

On Facebook, I recently came across this wonderful advice from Wives of PTSD Vets and Military.  I quote this useful advice below:

“If there is anything you have learned from your experience that you would tell those who are new to PTSD and the VA, what would it be?

Just A FEW of mine would be:

1. Staying on top of the VA and the veteran’s care is a full time job by itself. It is important to stay on top of it or they will fall through the cracks. Don’t wait for the VA to call. You call the VA.
2. Always research the severe side effects, and interactions of ALL medications including over the counter.
3. Always be aware of their moods, anniversaries (if possible), and seek help if you see them slipping downward.
4. Have a safety plan.
5. Find ways to communicate with your spouse. Use of code words, safety words etc are extremely helpful for us. Our new one is trust tree, which means either one of has something important to say, and the other one can’t judge, flip out, or start an argument. So far, it’s working. I’ll make a post later for it.

These are only a few off the top of my head. I have a lot more in depth ones that I will write about after while. What things have you learned or did you wish you knew when starting this roller coaster ride called PTSD?”

While one can only hope that this pragmatic spouse finds a sympathetic ear at the VA, “effective treatment” still seems out of reach.

In summary, may our brave Veterans and their families and friends get the HONEST SUPPORT THEY DESERVE.

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Partner Support Resources for Veterans with PTSD

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While Stand For The Troops (“SFTT”) primarily focuses on making sure Veterans with PTSD receive the therapy and support they deserve, we would be remiss in not acknowledging that Veteran families also suffer grievously from the “silent wounds of war.”

Caregiver for Veteran with PTSD

Indeed,  social media is inundated with heart-wrenching stories of partners of Veterans seeking advice and support of other Veteran partners on coping with the day-to-day problems of Veterans with PTSD and TBI.   In many cases, these partners (primarily wives) have benefitted from support groups in which they exchange advice and provide comfort to others as their husbands combat the demons of PTSD.

In fact, the Department of Veteran’s Affairs (“the VA”) has a “caregiver support line for partners of Veterans with PTSD.    That caregiver support line is 1-855-260-3274.

Indeed, the VA provides some useful advice on the advantages of joining a “peer support group” and how to locate them:

Joining a peer support group can help you to feel better in any number of ways, such as:

– Knowing that others are going through something similar

– Learning tips on how to handle day-to-day challenges

– Meeting new friends or connecting to others who understand you

– Learning how to talk about things that bother you or how to ask for help

– Learning to trust other people

– Hearing about helpful new perspectives from others

Peer support groups can be an important part of dealing with PTSD, but they are not a substitute for effective treatment for PTSD. If you have problems after a trauma that last more than a short time, you should get professional help.

Aside from the VA recommendations, many other independent organizations have sprung up to support partners who feel the need to exchange ideas and support one another during a particularly difficult period in their relationship.

Found below in no particular order are online support resources that may help provide a peer support forum to exchange ideas and advice:

Wives of PTSD Vets (Facebook Page)

A useful Facebook Page of engaged partners who seek to provide useful resources to others on helping wives of military Veterans with PTSD

Hidden Heroes

Established by Senator Elizabeth Dole, Hidden Heroes has as its mission to:

– Raise awareness of the issues military caregivers confront every day

– Inspire individuals, businesses, communities, and civic, faith and government leaders to take action in supporting military caregivers in their communities

– Establish a national registry, encouraging military caregivers to register at HiddenHeroes.org to better connect them to helpful resources and support

Family of a Vet

A practical guide, gleaned from contributions by its many members, on how to cope with PTSD and TBI.  More practical and common sense advice than clinical evidence, but certainly a recommended resource for those who require guidance and a helping hand.

PTSD Support Group

Essentially, a forum to exchange ideas and vent.  Clearinghouse for frustrations that emanate from being a caregiver for a Veteran coping with PTSD

Army Reservist Wife (Blog)

Authentic – pulls no punches – blog featuring genuine stories of how caregivers cope with the difficulties of sustaining a relationship with Veterans suffering from PTSD and TBI.

While there are many other notable online resources, local support groups that meet in person are probably far more effective than online advice.  Most base facilities provide programs for spouses of active duty personnel.

Veterans discharged from the military or reservists may find active support groups at religious centers or outreach programs supported by local community activists or charitable organizations.

Veterans suffering from PTSD and/or TBI value companionship.  While it may seem difficult to provide them the support they are seeking, it is a battle worth fighting valiantly.  Support groups may well provide the necessary resources one needs to persevere.

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